Alabama Dental

BCBS of Alabama

  • Emdeon Link
  • Payer ID – CBAL1
  • Must send at least 1 claim every 90 days
  • Fax forms to Emdeon Business Services at  860-289-0055

BCBS Enrollment Form

BCBS Change Of TAX ID Number Form

Medicaid of Alabama

  • Emdeon Link
  • Payer ID – CKAL1
  • Fax forms to Emdeon Business Services at  860-289-0055

Medicaid Enrollment Form

Medicaid Change Of TAX ID Number Form

National Payers Requiring Enrollment

UCCI

  • Direct Link
  • Payer ID – 89070 and 54771
  • If the office does not have a provider ID:
    • The office needs to call UCCI at (800) 633-5430, option 3, and let UCCI know that they will be submitting claims through Apex EDI.   Be sure to have them acknowledge every provider in the office that submits claims to UCCI.
  • If the office knows their provider ID you can submit the online form for them:
  • To Enroll for ERA’s:

Other National Payers Enrollment Forms